The Optimal Age for Oophorectomy in Women with Benign Conditions: A Narrative Review.

Objective

Oophorectomy is a common procedure for benign uterine conditions, historically recommended for women aged 40-45 and older due to the belief that ovarian preservation had no significant benefits. This review evaluates the literature on the optimal age for oophorectomy in women with benign conditions to assess its risks and benefits and guide clinical decision-making.

Methods

A narrative review was conducted using a literature search of articles published between January 2000 and February 2025, focusing on the age-related outcomes of ovarian conservation versus removal.

Results

Oophorectomy remains a complex decision in gynecological surgeries, especially among perimenopausal and postmenopausal women. Evidence supports ovarian conservation in average-risk women, highlighting reduced risks of cardiovascular disease, osteoporosis, and all-cause mortality. Conversely, oophorectomy is favored in high-risk populations, such as BRCA mutation carriers, due to significantly lower risks of ovarian and breast cancers. Despite declining rates, unnecessary oophorectomies persist, influenced by age, socioeconomic status, comorbidities, and surgical approaches. The development of a risk stratification tool offers promise for improving individualized decision-making.

Conclusions

The decision to perform oophorectomy for benign conditions should be personalized, balancing patient-specific factors to optimize outcomes and long-term health benefits.